Online Journal of Rural Nursing and Health Care, 1(3) 6 

Editorial 

Rural Practice Forum: Mental Health Services for Adolescents 

Bette Ide, PhD, RN, Editorial Board Member 

 

JoAnne Thompson, M.S., RN, a school nurse in Roseau, MN, discusses the urgent 

problem of mental health services for adolescents in rural areas and gives suggestions for ways 

the rural nurse can deal with them.  The acceptability and availability of mental health services 

for the adolescent population is at crisis levels in northern Minnesota and North Dakota.  

Adolescents in rural areas face isolation and loneliness, poor access to transportation, and 

increased economic conflicts (unemployment, divorce, poor housing, and poor nutrition), and 

lack of specialized mental health services.  Adolescents in rural areas might respond by increased 

‘escape’ risk taking behaviors of alcohol and/or drug abuse and sexual activity. 

Resiliency research has provided some cues to improve future orientation, active skill 

acquisitions, and positive risk taking behaviors.  Professionals can assist by always seeking the 

positive behaviors and reinforcing whenever possible.  Mentors are critical for all adolescents.  

Most adolescents make excellent mentors themselves if structured to enhance their positive 

attributes. 

Communities (especially faith communities) can foster resiliency by providing activities 

with responsible adult supervision.  Transportation is an issue with the isolated adolescent.  

Activities should be geared to immediately after school or church so transportation is only one 

occurrence.  Youth directors or parish workers would increase attendance if transportation is 

provided.  Schools need to provide opportunities for transitions to work or post-secondary 

endeavors.  Schools also need to offer a variety of activities for non-competitive activities.   



Online Journal of Rural Nursing and Health Care, 1(3) 7 

Medical clinics need to provide assessment for mental health with adolescent contacts.  

Opportunities for counseling need to be available.  Child mental health resources are “few and 

far between”.  An appointment for mental health assessment may involve a 120-mile drive, 

which means a day without employment for parents.  Professionals need to be sensitive to 

distance and attempt to have follow-up via phone or electronic communication. 

Education professionals need to consider a mental health screening when formal 

assessments are performed for attention deficit disorder and when behavioral indicators point in 

that direction.  School social workers need to be aware of the local resources.  All too often, 

parents dismiss the symptoms of depression as a ‘phase’ or ‘hormones’.  School personnel need 

to advocate for students when appropriate. 

Nurses in the public sector are excellent resources for adolescents.  Nurses ‘see the whole 

picture’ of adolescent, family, and community.  Nurses also need to explore the concept of 

resiliency for practical applications. 

Adolescents need to be saturated with caring adults.  Opportunities of “required 

volunteerism”, mentoring relationships, realistic short and long term goal setting, empowerment 

of parents, proactive skill building activities (especially refusal skills), consciousness raising 

community programming, are just a few of options that nurses can initiate or facilitate. 

For further information, email me at Bette_ide@mail.und.nodak.edu.